Provider Demographics
NPI:1548092463
Name:NATVIG, SAMUEL ZANE (DPT)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:ZANE
Last Name:NATVIG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 S PARKER RD STE A116
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2758
Mailing Address - Country:US
Mailing Address - Phone:720-389-9276
Mailing Address - Fax:720-746-9346
Practice Address - Street 1:1402 S PARKER RD STE A116
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2758
Practice Address - Country:US
Practice Address - Phone:720-389-9276
Practice Address - Fax:720-746-9346
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist